| Organization Name: | PHYSICAL THERAPY OF FERGUSON-FLORISSANT LLC |
| NPI Number: | 1578777256 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANET VANDERBECK (OWNER) |
| Mailing Address: | 10859 W Florissant Ave Ferguson |
| State: | MO US |
| Postal Code: | 631362405 |
| Phone Number: | 3145213000 |
| Fax Number: | 3145217800 |
| NPI Enumeration Date: | 05/10/2007 |
| NPI Last Update Date: | 07/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |